Ask the Experts on...Appendicular Adenocarcinoma?
I made a right hemicolectomy in a 73-year-old man for an appendicular abscess developed over 3 months. A computerized tomography (CT) scan and echography diagnosed the abscess with infiltration of the abdominal wall. Anatomo-pathology revealed an adenocarcinoma of the appendix (pT4N1), and liver was covered with infra-centimetric metastasis. What further treatment do I have to propose?

Additional surgical procedures are not warranted. Consideration should be given to consulting a radiation oncologist since this patient may benefit from local radiation therapy to the abdominal wall, given the fact that the tumor has extended and infiltrated the abdominal wall. Consideration should also be given regarding various chemotherapeutic protocols that may be used in this patient with extensive multiple hepatic metastases. Although these therapies may be considered in a relatively healthy 73-year-old, it is doubtful that these measures will significantly prolong the life of this patient with extensive metastatic disease.